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General NPI Number Information
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NPI Number | 1063852762
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Entity Type | Individual
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Provider Name | KHALID AL KATRANJI MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5165 MCCARTY LN
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City | LAFAYETTE
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State | IN
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Zip | 47905-8764
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Country | US
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Telephone | 765-448-8000
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Fax | 765-838-4758
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Provider Business Mailing Address
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Address Line | PO BOX 778912
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City | CHICAGO
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State | IL
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Zip | 60677-8912
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Country | US
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Telephone | 317-777-6435
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Fax | 317-777-6644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01079284A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 3-320
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 01079284A
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License Number State | IN
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